Sunday, January 28, 2018

What to Expect of Therapy and More


Retreat & Refresh Stroke Camp

a division of United Stroke Alliance

I started this series three weeks ago. Today, I'm concluding with more information that should be helpful in showing you what to expect during and after leaving the rehab facility.

As with the previous articles, this one was first posted on the American Stroke Association's StrokeConnection website by Jon Caswell:

Most IRF stroke programs have many elements to support the many aspects of stroke recovery. These may include:
  • individual therapies
  • group therapies
  • teaching strategies to compensate for functions that aren’t fully recovered
  • psychological, emotional support
  • establishing daily and weekly routines
  • goal setting
  • education on: cause of stroke; preventing another stroke; medications; diet; protection of skin; management of spasticity; stretching; caregiver training; community resources after discharge
Different members of the team handle different aspects. For example, secondary prevention is generally something a physician and member of the nursing staff do more than the therapists. On the other hand, setting functional goals tends to fall more to the therapists than the nurse and physician.
“Our goal is to get survivors ready to be discharged safely to their homes,” Harvey said. “Most of the time that involves individual therapy. Occasionally we give group therapy. We often have an upper-body exercise group for people who need to strengthen their weak arm. Or a speech group where patients communicate with each other under the supervision of a speech therapist, but mostly it’s individual therapy.”
In stroke rehab, there is constant balancing of recovery and compensation. In IRFs, the goal is to work on recovery first — strengthening arms and legs and using whatever strength is regained to help perform functional tasks. “In some cases, that’s impossible, so if a person’s balance is very severely impaired and walking is unsafe, we may shift focus to practice on wheelchair propulsion, which is a compensatory way to move around. But the goal is to help this person be able to do what they need to do as independently as possible. And that either is going to be recovery back toward normal performance or improvement of function based on compensatory strategies with or without devices.”

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